Death is one of life’s few certainties, and most GPs will inevitably preside over a few patient deaths each year. Indeed, the apotheosis of the ‘good death’ could be the patient who dies at home, dignified and pain-free following well-coordinated interdisciplinary palliative care.1 Given that around three-quarters of people express a wish to die at home2 yet only a quarter manage to do so,3 that sentiment appears to have wide public support. Nonetheless, in common with many aspects of clinical medicine, death is riddled with uncertainty, especially when it occurs unexpectedly, these being relative rather than absolute terms. In this essay we discuss two cases from our clinical practices, one occurring in the community that went to post-mortem, and another occurring in hospital which did not. This is followed by a discussion whose main theme centres on the role of the coroner post-mortem service, and explores the evidence for alternatives to traditional autopsy. A 59-year-old male was found by his carer having unexpectedly died at home. His GP attended and he was noted to be on the floor, collapsed in the foetal position on the floor by his bed. His home nebuliser mask was on his face. There was evidence of heavy alcohol intake with numerous beer and wine bottles by the bed, and also of heavy smoking with several ashtrays filled with cigarette butts. There were no suspicious circumstances so the body was moved to the mortuary, but the uncertainty of cause of death led to a referral to the coroner. The patient’s significant medical history included asthma, hypertension, peripheral vascular disease, and chronic alcoholism complicated by myopathy. He lived alone, having been widowed some years before, and his self-care was poor. The salient findings at post-mortem noted an underweight man looking older than his age, …